Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | CO | |
Y | 103T00000X | Psychologist | CO |
NPI | 1013311810 |
---|---|
Provider Name | Molly Mclaren |
First Address | Fort Collins, CO 80524-3184 |
Second Address | Fort Collins, CO 80524-3184 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2014 |
Last Update Date | 22/10/2014 |